In the fall of 2021, FLOURISH community leaders, organizational partners and Generate Health staff participated in reflection sessions to identify where they have seen systems change contributing to greater health equity for Black pregnant and parenting individuals and their babies in St. Louis.

The reflection sessions focused on three systems change goals established in the FLOURISH Theory of Change. These include:

• Policymakers and systems leaders actively listen to and incorporate community voice
• Black providers are elevated as experts
• Entities that work on reducing infant mortality are coordinated and aligned.

Participants in the reflection sessions elevated where progress has been made in the region and where there are opportunities to further advance the priorities of FLOURISH.

Read the highlights below and for a deep dive, read the full memo prepared by FLOURISH’s evaluation partner, Learning for Action.

FLOURISH Evaluation Learning Memo

Systems change goal #1: Policymakers and systems leaders actively listen to and incorporate community voice

How FLOURISH is making progress toward this goal:

• FLOURISH is building the community’s capacity to be storytellers and advocates for infant wellbeing
• FLOURISH is facilitating new channels of communication between community members, policy and systems leaders

What more is needed to achieve this goal?

• Leverage the power of social media to meet families where they’re at and lift community voice
• Help families feel more connected by using a storytelling approach to increase awareness of infant mortality and mitigate feelings of shame, overwhelm, grief, and confusion as the result of infant loss.
• Continue educating community members about relevant policies that could impact the health and wellbeing of Black families and infants
• Develop a pipeline to policymaker to support the representation of community members in political decision making

Systems change goal #2: Black providers are elevated as experts

How FLOURISH is making progress towards this goal:

• FLOURISH assigns true decision-making authority to community members through its Community Leaders Cabinet and Community Review Committee
• FLOURISH is putting financial support in the hands of Black-led organizations through its community-led investment portfolio
• Black community leaders feel that their experiences and voices are valued
• FLOURISH is elevating the need to increase the workforce of Black doulas and midwives and recognizing their contribution to the health and wellbeing of Black women, birthing people, and their babies.

What more is needed to achieve this goal?

• Increase advocacy to address health system barriers that limit access to doulas and midwives
• Address barriers to doula care that have been exacerbated in the wake of COVID-19
• Continue to support the expansion of the workforce of Black providers, including doctors, nurses, midwives, doulas, and social workers
• Increase community awareness and commitment to advancing racial equity among all providers

Systems change goal #3: Entities that work on reducing infant mortality are coordinated and aligned

How FLOURISH is making progress toward this goal:

• FLOURISH is serving as a powerful convener and connector, building a coalition of providers, grassroots organizations, community members, and allies working toward a similar goal
• Community voice plays a crucial role in aligning efforts and FLOURISH has created opportunities to engage and uplift community voice
• FLOURISH’s COVID-19 response grants built new connections and trust with Black-led organizations that are working to reduce infant mortality in St. Louis

What more is needed to achieve this goal?

• Meaningful opportunities to convene would support organizations to make collaboration even more robust
• A critical examination of funding mechanisms perpetuating work in siloes must be addressed

The community leader perspective in the evaluation of FLOURISH’s progress comes at an important moment for FLOURISH. Through the first half of 2022, FLOURISH is engaging in strategic planning to identify future efforts of the initiative and the resources that will sustain this work. We invite our Community Leader’s Cabinet and Black community members with lived experience to share their perspectives and uplift the strategies that FLOURISH can champion to support Black moms, babies and families to help us reach the North Star of zero racial disparities in infant mortality by 2033.